The moment a settlement is reached, a second set of claimants appears: every entity that paid a medical bill and now wants its money back. This article explains who those claimants are, where their rights come from, and why the answer differs so completely between a self-funded employer plan, an insured plan, Medicare, Medicaid, and a hospital with a statutory lien. It covers the equitable-lien theory that governs employer plan recovery, the made-whole and common fund doctrines that reduce it, and the single defense that has actually defeated a plan's claim. It then covers the federal programs whose recovery rights are statutory and largely non-negotiable, and the state-law liens that vary enormously. It closes with the practical sequence for resolving every lien on a settlement before it is disbursed.